IMAGING ASSOCIATES OF CANTON (NPI# 1932155355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932155355 |
| Entity Type | Organization |
| Organization Name | IMAGING ASSOCIATES OF CANTON |
| Practice Address |
200 Oakside Ln Suite A Canton GA 30114-6415 |
| Practice Telephone | 7704791945 |
| Practice Fax Number | 7704791948 |
| Mailing Telephone | 7704791945 |
| Mailing Fax Number | 7704791948 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2008-04-25 |
| Authorized Official Name | DR. BRADLEY ROBERT PETERS (PRESIDENT / MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7704791945 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000964268L | 05 | |
| GA | WELLCARE | 319443 | 01 |
| GA | AMERIGROUP | 10051310 | 01 |
| GA | PEACHSTATE | 129908 | 01 |
| Street Address |
200 OAKSIDE LN SUITE A |
| City | CANTON |
| State | GA |
| Zip Code | 30114-6415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374262 | Bradley Robert Peters | Radiology | 200 Oakside Ln, Ste A, Canton, GA 30114-6416 | 2005-05-27 |
| 1457640831 | Canton Specialty Imaging, LLC | Specialist | 200 Oakside Ln, Suite A, Canton, GA 30114-6416 | 2011-04-06 |
| 1306086228 | Kennestone Heart Physicians Group | Internal Medicine | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2009-03-05 |
| 1588774467 | Teru Kay Lapaquette | Obstetrics & Gynecology | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780937508 | American Health Imaging of Ga LLC | Clinic/Center | 100 Liberty Blvd Ste 100, Canton, GA 30114-2841 | 2012-10-17 |
| 1609162585 | D A Imaging, Inc. | Clinic/Center | 2000 Village Professional Dr, Suite 100, Canton, GA 30114-8494 | 2011-06-20 |
| 1356520613 | Catx, Inc | Clinic/Center | 1421 E Peace St, A, Canton, MS 39046-4938 | 2007-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101701 | Clear Imaging LLC | Clinic/Center | 5730 Glenridge Dr Ste T300, Sandy Springs, GA 30328-5871 | 2020-07-07 |
| 1881218964 | American Health Imaging of Georgia LLC | Clinic/Center | 30 Janet Dr, Savannah, GA 31405-5518 | 2020-06-03 |
| 1952948291 | Catching Point Physician Centers, LLC | Clinic/Center | 3333 Old Milton Pkwy Ste G100, Alpharetta, GA 30005-0008 | 2019-12-05 |
| 1447802780 | American Health Imaging of Ga LLC | Clinic/Center | 2851 Washington Rd, Augusta, GA 30909-2131 | 2019-07-16 |
| 1700445582 | American Health Imaging of Ga LLC | Clinic/Center | 4374 Atlanta Hwy Ste 125, Hiram, GA 30141-1852 | 2019-06-06 |
| 1508425380 | American Health Imaging of Ga LLC | Clinic/Center | 796 Church St Ne Ste 100, Marietta, GA 30060-7228 | 2019-06-06 |
| 1588229918 | Synergy Radiology, LLC | Clinic/Center | 6025 Professional Pkwy Ste 104, Douglasville, GA 30134-5610 | 2019-05-01 |
| 1134645351 | M & B Imaging, PC | Clinic/Center | 2485 Jefferson Rd, Athens, GA 30607-1202 | 2017-08-18 |
| 1548785330 | American Health Imaging of Georgia LLC | Clinic/Center | 1103 Fountain Lake Dr, Brunswick, GA 31525-3039 | 2017-08-14 |
| 1164966461 | Pro Radiology, LLC | Clinic/Center | 60 Peachtree Park Dr Ne, Atlanta, GA 30309-1304 | 2016-12-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.